As a doula I’ve seen a lot of births. Over 300 in fact.
Seems everyone comes into the labor process hoping for a positive experience, and dreading a negative one. Looking at the stories in this culture and it’s easy to see where these fears comes from. The birth world is littered with stories of traumatic births or births where things didn’t go the way Mom was hoping. But there is a difference between having things go differently, and having that difference be a negative experience. What I saw in my years of being a doula was that the difference between a satisfying and unsatisfying birth usually came down to whether Mom was able to work with the events of her labor, or if she blindly accepted what happened or resisted changing circumstances. Everything in Labor is workable. Anything that might happen can be examined and dealt with, or it can be pushed away and resisted. Resisting isn’t working with something, it’s pushing it away. Working with your labor can lead to a more satisfying outcome, regardless of the circumstances, because you are able to stay present and make decisions you need to make at the time you need to make them.
When I became pregnant with my son I was 7 months out from having run my first- and to date only- Ironman Triathlon. For those who don’t know, this is a somewhat ridiculous distance event involving 140.6 miles of swimming, biking and then running. When I decided to run this event and began telling people I found myself getting one of two responses. “Wow! You’re so ____ “(brave, strong, determined, etc -insert impressed adjective here), or “Why would you want to put yourself through something like that!?” Oddly enough, when I informed people that I wanted to have an un-medicated labor (and in fact that I was planning a home birth), I got many of the same responses. Faced with either event, people seemed both amazed and more than slightly confused that someone might attempt such a feat. I mention this not because any pregnant woman should undertake the idea of running an Ironman, but because the two actually have aspects in common. While I was training for the triathlon I happened upon a training plan called “The Four Keys to long course triathlon success”. These were principles to apply both during preparation and on the day of the event. When I became pregnant, I realized much of my birth preparation was following the same format. As a longtime childbirth educator and doula I sought to better understand how these two events intersected, which led me to write down what I call the Four Cornerstones to working with labor.
Cornerstone #1: Labor is not about pain. It is about your mental attitude.
How you focus on things dramatically affects how you experience them. This means that whether you have a high or low pain threshold isn’t the point. The point is how able are you to focus your mind in a specific way? Can you feel something, maybe even something painful without needing it to go away? Wanting things to be easy isn’t bad, seeking comfort isn’t a problem. The problem is not accepting that this is how things feel right now is, because it starts by denying reality. Key to preparing for labor is the process of preparing your mind to work with strong sensations and strong emotions, because both are likely to come up.
Cornerstone#2: You have to stay on “your mat”.
Let’s imagine you are on your yoga mat. Everything on your yoga mat is something within your ability to control. Your body position, your breathing, where you place your attention and so on. Everything off your mat is something you do not control. Whether the person next to you is breathing heavily, or sweating too much. Whether the teacher comes over to you or not, these are outside what we can control. Now extrapolate this to your labor. There are things about your labor you will be able to control; where you choose to birth, your fitness level in pregnancy, your breathing, how you react to what people tell you about their pregnancies or how you react to the comments they make. These are all on “your mat” but there are things you don’t control which are off “your mat”. We don’t control when we go into labor (even with Pitocin you don’t know if it will actually work). We don’t control how long our labors will be, or what exact position the baby is in when we start to labor and birth. We don’t control other people’s reactions to our pregnancy, or whether our friends or relatives call asking if we’ve had the baby yet, and so on. For the purposes of working with your labor the key is to stay on your mat. Just focus on the things you can control and let go of the rest. Not an easy task, but a vital one for working with what comes up during the birth process. (Note this will also be true after the baby comes- but that’s later)
Cornerstone #3: The Tunnel
I’m not talking about the tunnel/canal/path the baby navigates out of your pelvis. I’m talking about the point in labor when everyone goes into some sort of mental tunnel; when you begin to shut out the rest of the world and just do whatever you need to do to work with the contraction. This is the point where you engage with the labor process. The tunnel is often dark, often scary, (it is after all, a tunnel!) and often things don’t feel good in there. We don’t know how long our individual labor tunnel is but we do know that the baby is on the other side of it. The end of the tunnel is the end of your labor, but here’s the thing, when you enter the tunnel is going to depend on what you did during the early portion of your labor. If you recognized your first contraction and immediately told everyone you were in labor and began using every labor coping technique you learned in books, or from a childbirth class you took, rather than speeding up your labor, you would only speed up when you had to enter the tunnel. You would actually prolong your labor by making labor more challenging before it needed to be. You want to get to the tunnel, well rested, well fed, and hydrated, supported by the people you need around you to feel safe. Delay the tunnel as long as possible. Distract yourself, fuel and nourish your body so that you push the opening of the tunnel as far back as possible, maybe even beyond the physical moment of your baby’s birth.
Cornerstone #4: The magical thought…
Once you’re in the tunnel the question is what can you tell yourself to keep moving forward and come out the other end? This is where you might tap into the reason you chose to birth in this manner, or remind yourself of a phrase or mantra that has meaning for you. What the exact phrase is, is going to depend on you. Maybe you have full and complete faith in your body and the birth process and you can tell yourself you trust what is going on. Maybe you remind yourself of how you wanted a specific birth for the experience and health it might bring your baby. Maybe you simply remind yourself that what you are experiencing will pass. The point is find a phrase which resonates for you and have it in your back pocket. In the moment when you feel you can’t go on, and that you want to just give up, remember your magical phrase and use it to inspire you. And you won’t have just one phrase. Have multiples. When one thought stops being effective switch to something else. Start with reminding yourself of how strong you are and then switch to simply saying that this will end. Whatever works, just keep working with it.
This isn’t to say you won’t wind up availing yourself of the pain relief and medical options which are available in western medicine. It is quite possible that in the process of working with your mind, the sensations, and staying with what you can control you will decide that the right choice for you is an epidural, or even a surgical birth. If you make this choice from a calm space, especially if it wasn’t your first choice for your labor, then good for you for working with all the options available. As was stated back in cornerstone #2 we can only control what we can control, and sometimes we didn’t know our own tunnel with this baby was going to be hours upon hours longer than expected. In that case, using the tools available is still working with your labor.
Working with the labor process is the key. However the birth of this child unfolds, we want to walk away from that experience feeling empowered, confident, and overjoyed with the little being now in our arms. Even if this birth unfolds completely differently from how you might have initially desired, at the end of the day can we say that we worked with what came up for us? That we were active rather than passive in our decision making? We made the right choices with the information we had available in the moment? If we can do that then we stand a much better chance of being able to be fully present in that moment when our babies come into our arms. I planned a home birth for the birth of my son, and he was born via unplanned cesarean in a hospital. I credit the fact that I still feel I had a positive birth experience to the fact that I was able to work with my labor, rather than be powerless against it.
And being present for that moment when the baby first looks into your eyes is the most incredible experience of the whole birth process